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F-18-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu's arteritis

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Title: F-18-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu's arteritis
Authors: Incerti, E
Tombetti, E
Fallanca, F
Baldissera, EM
Alongi, P
Tombolini, E
Sartorelli, S
Sabbadini, MG
Papa, M
De Cobelli, F
Mason, JC
Gianolli, L
Manfredi, AA
Picchio, M
Item Type: Journal Article
Abstract: Purpose The object of this study was to assess whether 18F-fluorodeoxyglucose PET/CT (FDG PET/CT) provides novel information in patients with Takayasu’s arteritis (TA) in addition to that provided by current activity assessment, to analyse the effects of possible confounders, such as arterial grafts, and to verify whether PET/CT could be informative in lesions <4 mm thick. Methods We studied 30 patients with TA, evaluated from October 2010 to April 2014 by both PET/CT and magnetic resonance imaging (MRI). All arterial lesions were evaluated by PET both qualitatively (positive/negative) and semiquantitatively (maximum standardized uptake value, SUVmax), and the thickness of lesions in the MRI field of view was evaluated. In a per-patient analysis, the relationships between the PET data and acute-phase reactants and NIH criteria for active TA were evaluated. In a per-lesion analysis, the relationships between the PET features of each lesion and MRI morphological data were evaluated. The effects of the presence of arterial grafts were also evaluated. Results Increased FDG uptake was seen in 16 of 30 patients (53%) and in 46 of 177 vascular lesions (26%). Significant periprosthetic FDG uptake was seen in 6 of 7 patients (86%) with previous vascular surgery and in 10 of 11 of grafts (91%). Graft-associated uptake influenced the PET results in three patients (10%) and the SUVmax values in five patients (17%). Of 39 lesions with significant FDG uptake, 15 (38%) were <4 mm thick. Lesion thickness was correlated with lesion SUVmax in FDG-avid lesions only. FDG arterial uptake was not associated with systemic inflammation or NIH criteria. Conclusions PET/CT reveals unique and fundamental features of arterial involvement in TA. PET/CT may be useful in the assessment of local inflammatory and vascular remodelling events independent of systemic inflammation during follow-up, even in lesions in which the arterial wall is <4 mm. The presence of arterial grafts is a potential confounder. Prospective studies are required to correlate PET findings with relevant clinical outcomes.
Issue Date: 8-Feb-2017
Date of Acceptance: 25-Jan-2017
URI: http://hdl.handle.net/10044/1/50574
DOI: https://dx.doi.org/10.1007/s00259-017-3639-y
ISSN: 1619-7070
Publisher: Springer Verlag
Start Page: 1109
End Page: 1118
Journal / Book Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 44
Issue: 7
Copyright Statement: © Springer-Verlag Berlin Heidelberg 2017
Keywords: Science & Technology
Life Sciences & Biomedicine
Radiology, Nuclear Medicine & Medical Imaging
Takayasu's arteritis
Disease activity
FDG PET/CT
MRI
Arterial grafts
Vasculitis
DISEASE-ACTIVITY
EMISSION-TOMOGRAPHY
PROGNOSIS
PET/MRI
WALL
CT
IMPROVEMENT
MANAGEMENT
VASCULITIS
DIAGNOSIS
Takayasu’s arteritis
1103 Clinical Sciences
0299 Other Physical Sciences
Nuclear Medicine & Medical Imaging
Publication Status: Published
Appears in Collections:National Heart and Lung Institute